Alternative organic fungicides for apple scab management and their non-target effects

A major challenge in organic apple production in humid production regions is the available fungicide options for apple scab [Venturia inaequalis (Cooke) Wint.] management. The standard sulfur/lime sulfur fungicide program can be injurious to the applicator, the apple ecosystem, and the apple tree itself. The objectives of this study were to compare the efficacy of three potential alternative fungicides [potassium bicarbonate (PB), neem oil (NO), and Bacillus subtilis (Bs)] with a standard organic sulfur/lime sulfur (SLS) fungicide program and a non-treated control (NTC) for management of apple scab and to evaluate potential non-target impacts on pest and beneficial arthropod populations. The five treatments were applied to \u27Empire\u27 trees arranged in a completely randomized design with five single-tree replications at the University of Vermont Horticultural Research Center in South Burlington, VT. Fungicides were applied with a handgun to drip using maximum label rates. Applications began on 26 Apr. 2007 and 23 Apr. 2008 and continued on approximately a weekly schedule through the end of June and then every 2 weeks through 23 July 2007 and 17 July 2008, respectively. The standard SLS treatment resulted in the best scab control in both years. TheNOtreatment reduced foliar and fruit scab compared with the NTC and the other alternatives at the end of the 2008 growing season and had insecticidal activity. However, both the SLS and NO treatments had disadvantages, including phytotoxic burning on the fruit and/or significantly more russeting on the fruit at harvest. In each year of the study, one or more of the alternative treatments, particularly Bs, resulted in higher insect damage than the non-fungicide-treated control. This research showed that PB, Bs, and NO do not offer advantages over the standard SLS fungicide program in organic apple production and in some cases offer distinct disadvantages in terms of non-target impacts. Chemical names used: potassium bicarbonate (Armicarb O ), Bacillus subtilis (Serenade MAX), neem oil (Trilogy), sulfur (Microthiol Sulfur)/lime sulfur (Miller Lime Sulfur)

Primary care physicians' use of family history for cancer risk assessment

<p>Abstract</p> <p>Background</p> <p>Family history (FH) assessment is useful in identifying and managing patients at increased risk for cancer. This study assessed reported FH quality and associations with physician perceptions.</p> <p>Methods</p> <p>Primary care physicians practicing in two northeastern U.S. states were surveyed (n = 880; 70% response rate). Outcome measures of FH quality were extent of FH taken and ascertaining age at cancer diagnosis for affected family members. Predictors of quality measured in this survey included: perceived advantages and disadvantages of collecting FH information, knowledge of management options, access to supportive resources, and confidence in ability to interpret FH.</p> <p>Results</p> <p>Reported collection of information regarding second degree blood relatives and age of diagnosis among affected relatives was low. All hypothesized predictors were associated with measures of FH quality, but not all were consistent independent predictors. Perceived advantages of taking a family history, access to supportive resources, and confidence in ability to identify and manage higher risk patients were independent predictors of both FH quality measures. Perceived disadvantages of taking a family history was independently associated one measure of FH quality. Knowledge of management options was not independently associated with either quality measure.</p> <p>Conclusions</p> <p>Modifiable perception and resource factors were independently associated with quality of FH taking in a large and diverse sample of primary care physicians. Improving FH quality for identification of high risk individuals will require multi-faceted interventions.</p

Breast Cancer and Internal Mammary Sentinel Nodes: A Meta-Analysis

Background: The management of internal mammary (IM) nodes in breast cancer lacks a well-defined consensus. Lymphoscintigraphy identifies up to one-third of breast cancer patients with extra-axillary drainage, which is mainly located in the IM chain. Our aim in this meta-analysis is to identify the lymphoscintigraphy technique variables that effect IM node identification. Methods: An internet database was utilized to review articles concerning sentinel nodes and breast cancer from 1993 through the end of 2011; 74 articles met our inclusion criteria. The total number of patients included was 22959. We grouped the citations by injection location and injection material. We then analyzed the rate of identification of IM nodes according to these groupings and their subsets. Results: The overall IM identification rate using the random effect model was 9%. The injection location had the most significant impact on IM identification rate; the deeper injections were associated with the highest rate of identification. Variation in IM identification was associated with the particle size of injection material; the smaller particle size group had a higher rate of identification. Increased dose of the tracer was also associated with increased identification rate. Conclusions: The use of smaller particle size tracers and a deeper injection location achieve the highest IM identification rate. The dose of the tracer also increased the identification rate. These observations can help in the selection of patients for IM sentinel node biopsy, which can affect their prognosis and treatment management

Measuring the nursing workforce: Clarifying the definitions

Numerous articles have addressed the causes and implications of the current nursing shortage. Little has been published, however, about how to measure the nursing workforce. This article presents (1) a review of definitions for common workforce indicators such as vacancy and turnover rates and the relationship between these indicators and the need for nurses, (2) a review of the calculation of vacancy and turnover rates in several statewide and national surveys, and (3) the results from the development and pilot test of a health care workforce survey for use in Vermont. The review indicates that in practice, no standard method is used despite attempts to standardize the calculation of vacancy and turnover rates. The Vermont pilot study results demonstrate that a richer profile of the health workforce can be obtained by using both standard workforce measures and more subjective questions to assess a statewide need for nurses. © 2005 Sage Publications

National Institutes of Health Pathways to Prevention Workshop: the role of opioids in the treatment of chronic pain.

This National Institutes of Health (NIH) Pathways to Prevention Workshop was cosponsored by the NIH Office of Disease Prevention (ODP), the NIH Pain Consortium, the National Institute on Drug Abuse, and the National Institute of Neurological Disorders and Stroke. A multidisciplinary working group developed the workshop agenda, and an evidence-based practice center prepared an evidence report through a contract with the Agency for Healthcare Research and Quality to facilitate the workshop discussion. During the 1.5-day workshop, invited experts discussed the body of evidence, and attendees had opportunities to provide comments during open discussion periods. After weighing evidence from the evidence report, expert presentations, and public comments, an unbiased, independent panel prepared a draft report that identified research gaps and future research priorities. The report was posted on the ODP Web site for 2 weeks for public comment. This article is an abridged version of the panel's full report, which is available at https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/opioids-chronic-pain/workshop-resources#final report

National Institutes of Health Pathways to Prevention Workshop: The Role of Opioids in the Treatment of Chronic Pain

This National Institutes of Health (NIH) Pathways to Prevention Workshop was cosponsored by the NIH Office of Disease Prevention (ODP), the NIH Pain Consortium, the National Institute on Drug Abuse, and the National Institute of Neurological Disorders and Stroke. A multidisciplinary working group developed the workshop agenda, and an evidence-based practice center prepared an evidence report through a contract with the Agency for Healthcare Research and Quality to facilitate the workshop discussion. During the 1.5-day workshop, invited experts discussed the body of evidence, and attendees had opportunities to provide comments during open discussion periods. After weighing evidence from the evidence report, expert presentations, and public comments, an unbiased, independent panel prepared a draft report that identified research gaps and future research priorities. The report was posted on the ODP Web site for 2 weeks for public comment. This article is an abridged version of the panel's full report, which is available at https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/opioids-chronic-pain/workshop-resources#final report